Goals and strategies for pain management plan
Once a pet is diagnosed with OA at any stage, veterinarians can create a detailed pain management plan with these goals:
- Create an individualized strategy based on patient’s OA stage, signs, quirks, and family lifestyle
- Alleviate pain
- Slow down disease progression
- Increase stage-based exercise to improve mobility in the long term, which can fend off loss of muscle mass that often comes with later OA stages
- Mitigate any compounding factors (weight, diet)
- Set up clients’ roles and expectations for better compliance and success
Elements of a good pain management plan include foundational recommendations about diet, weight management, and stage-appropriate exercise. Those are your staples. Every pain management plan will address them in some way. For example, in the early stages of OA, pets typically remain fit with good mobility and muscle mass. This gives you many more options for exercise recommendations than a pet with a later stage of OA, who is already showing loss of muscle mass and mobility challenges.
Questions to Ask. Once you’ve determined those baseline strategies, consider several factors about the patient and client. Ask yourself these questions.
- Is an NSAID appropriate at this time? (Hint: The answer is often “yes,” at least in the short term.)
- Which NSAID is best suited to this case and this pet, if NSAIDs become one of your pain management plan recommendations?
- What other pain management modalities are appropriate, accessible, and doable for this case and client?
- What personality quirks or other practical details limit options? These might include that the pet is a terrible pill-taker or that the only underwater treadmill is 75 miles away.
Specific Recommendations. Pain management plans require discipline and specifics. Don’t toss out platitudes like, “Your pet should get more exercise.” Instead, be almost too specific. Phrase recommendations like this: “Take your dog on two 15-minute walks per day, every day.”
Follow-up Plans. Make sure clients understand that pain management isn’t a one-time visit, one-time fix. Explain and set expectations for the kinds of ongoing information you need them to share with you and how often and how many recheck visits will be needed to monitor and evaluate the plan’s success. These visits may include blood work, depending upon the pain medications prescribed.
Set expectations, as well, for when and why clients should contact you in between planned recheck visits, if they notice any changes in the pet, such as more signs of pain, increased limping or mobility issues, any physical or behavioral changes that may indicate a side effect, and any problems that come up with implementing the pain management plan at home.